I've had a particularly difficult (and frustrating) week caring for several patients with very severe diabetic foot infections. I’ve been at this for about 35 years now, but it doesn’t seem to be getting any easier. Perhaps the patients are just getting more complex and sicker or perhaps the pathogens are getting more virulent. Regardless, the infections just seem to be getting more difficult to control. While we have many more antimicrobial agents than we did years ago, antibiotics are only part of the solution to managing foot infections in the diabetic patient. We certainly need to have a very good understanding of the spectrum of coverage (and gaps in coverage) for a number of different agents. But the reality is, antibiotics alone can most often NOT be relied on to be the “magic bullet” for managing such complications. In fact, a good friend of mine who specializes in such matters is known to advocate that “draino” is the best (and perhaps the most important) agent for treating diabetic foot infections (DFI). Others can do a better job than I of discussing the multitude of antimicrobial therapies available for treating such infections (and perhaps it might be the subject of a future discussion).


Hence, I will focus here on the non-pharmacologic principles of assessment and management that are critical to success in this regard. For the purposes of our discussion, we will concentrate primarily on limb threatening (moderate or severe) infections...click here to read the full eZine article. Follow this link to read Part 2, The Challenges of Diabetic Foot Infections.

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